Smoking cessation strategies in patients with COPD

Abstract

Smoking cessation is the cornerstone of treatment of chronic obstructive pulmonary disease (COPD) patients. This systematic review evaluates the effectiveness of behavioural and pharmacological smoking cessation strategies in COPD patients.MEDLINE was searched from January 2002 to October 2011. Randomised controlled trials evaluating the effect of smoking cessation interventions for COPD patients, published in English, were selected. The methodological quality of included trials was assessed using the Delphi list by two reviewers independently. The relative risks of smoking cessation due to the intervention, compared with controls, were calculated.Eight studies met the inclusion criteria. Heterogeneity was observed for study population, the intervention strategy, the follow-up period and the outcome. According to the Delphi list methodological quality scores, five studies were considered to be of acceptable quality. Pharmacological therapy combined with behavioural counselling was more effective than each strategy separately. In COPD patients, the intensity of counselling did not seem to influence the results, nor did the choice of drug therapy make a difference.This systematic review makes clear that in COPD patients, pharmacological therapy combined with behavioural counselling is more effective than each strategy separately. Neither the intensity of counselling nor the type of anti-smoking drug made a difference.

Interrelated role of cigarette smoking, oxidative stress, and immune response in COPD and corresponding treatments

“…It was reported that counseling, pharmacotherapy treatments, and NRT are also effective (53,119,124,127,133). According to two independent systematic reviews by Warnier et al (135) and van der Meer et al (129), pharmacological and behavioral (psychosocial) intervention was more effective than no intervention. Furthermore, both of the reviews concluded that a combination of pharmacological and behavioral (psychosocial) intervention was more effective than each alone.…”

South African tobacco smoking cessation clinical practice guideline

“…Smoking cessation is a critical component of the effective management of COPD. [11] Savings of disposable income, achieved by quitting smoking, would also be available for basic necessities, particularly for those living in poverty.…”

New Pharmacological Agents to Aid Smoking Cessation and Tobacco Harm Reduction: What Has Been Investigated, and What Is in the Pipeline?

“…It is also the only drug which has proven long-term efficacy in smokers with chronic obstructive pulmonary disease [394,395] and is efficacious for patients with psychiatric disorders [396]. The introduction of varenicline in the US appeared to coincide with a net overall increase in both aided and unaided attempts to quit smoking [40]; although a similar effect was not seen in the UK [57,397].…”